Lymphomas

Amalgam Tattoo Biopsy

Lymphomas comprise Hodgkin's disease and non-Hodgkin's lymphoma. Non-1 Iodgkin's lymphoma usually arises from B lymphocytes and ihe different variants result from the stage of development of the lymphocyte undergoing neoplastic change. The cell of origin of Hodgkin's disease is uncertain but may be the monocyte or T lymphocyte. Lymphomas particularly Hodgkin's disease arc rare in the mouth, far more commonly affecting cervical lymph nodes, but are considerably more frequently seen in patients...

Infective stomatitis

Stomatitis

Aetiology A primary infection of a non-immune individual by HSV usually type 1. There is a steadily declining incidence in developed countries but increased prevalence in immunodeficiency, e.g. AIDS. Pathology Viral infection of epithelial cells produces intraepithelial vesicles Fig. 134 with virus-damaged cells in the floor Fig. 135 leading to epithelial destruction Fig. 136 , ulcers and inflammation. Smears from early lesions show ballooning degeneration of epithelial cell nuclei viral...

Squamous cell carcinoma

Squamous Cell Carcinoma Survival Rate

Aetiology and Aetiological factors usually unidentifiable although pathology widely regarded as related to tobacco and alcohol use. However, in Britain, oral cancer incidence in men has steadily declined while cigarette and alcohol consumption has increased. There is a closer relationship with pipe smoking. The high incidence of oral cancer in India is possibly related to different types and forms of tobacco usage. HPV 16 and related strains have been implicated, possibly by triggering mutation...

Noninfective stomatitis

Sjogrens Rash Pictures

Non-spccific ulceration can result from trauma or unidentified causcs as in recurrent aphthae. Aetiology Unknown in most cases. Many reported immunological abnormalities, but their aetiological significance is doubtful. This is not an autoimmune disease it affects otherwise healthy persons, and is not associated with recognized autoimmune diseases. There are no useful immunological diagnostic tests and there is no reliable response to immunosuppressive treatment. In 5-10 of cases, ulcers arc...

Keratoses leukoplakias white lesions

Frictional Keratosis

Leukoplakias are chronic white kcratotic mucosal plaques which are not due to any identifiable disease. The term is purely clinical and has no histological implications, but histology' is necessary to cxcludc malignancy or other diseases. Most leukoplakias arc not premalignant but red lesions erythroplasias pp. 95 96 are frequently precancerous or invasive carcinoma. Terminology Oral white plaques share many histological features, and idiopathic forms are often not distinguishable...

Osteosarcoma

Soft Tissue Rare Pathological

The most common primary tumour of bone. It is a rare complication of radiotherapy or Paget's disease of the axial skeleton. Osteosarcoma usually affects young persons, particularly males. Microscopy Appearances are variable and the tumour is either predominantly osteolytic undifferentiated or productive, and then may be predominantly osteochondroblastic or fibroblastic. It consists of abnormal tumour osteoblasts, which are typically angular, hyperchromatic and larger than normal often in large...

Nonneoplastic bone diseases

Resting And Reversal Line Pagets Disease

This is a nonspecific term encompassing diseases ranging from fibrous dysplasia to the well-circumscribed lesions of ossifying fibroma and uncommon, apparently intermediate, types. It is a controversial area, with diagnosis dependent on consideration of clinical and radiographic features, microscopy and behaviour. Typically seen in young adults of either sex as rounded, painless, smooth bony swelling of the maxilla. The swelling may disturb function or occlusion. Radiography shows a rounded...

Cementomas and cemental dysplasias

Periapical Granuloma Mice

The tumour usually affects males under 25 years. It appears as a radiopaque apical mass with radiolucent margin, usually in the molar region. Microscopy A rounded or irregular mass of ccmcntum can be seen on the root of the tooth Figs 100 amp 101 . The ccmcntum is in a pagetoid 'mosaic' pattern with many ccmcntoblasts Fig. 102 , a peripheral zone of pericementum and a zone of uncalcified cement matrix precementum and fibrous pericementum. Cementifying ossifying fibroma Most often found in the...

Periodontal radicular cysts

Periodontal Cyst

Aetiology Pulp death, apical periodontitis, proliferation of epithelial rests of Malassez, cystic change in epithelium expansion of cyst by hydrostatic pressure resorption of surrounding bone. Incidence 65-75 of jaw cysts. Periodontal cysts are the most common cause of chronic swellings of the jaws. chronic inflammatory infiltrate bony shell undergoing progressive resorption. The epithelial lining is stratified squamous in type and very variable in thickness sometimes with arcadcd configuration...

Periodontal lateral abscess

Periodontal Lateral Abscess

Aetiolo amp Usually a complication of advanced periodontitis. It may be due to injury to the pocket floor food-packing or more virulent infection. Pathology Rapid acceleration of periodontal destruction. Destruction of epithelial pocket lining. Dense neutrophil infiltrate and suppuration Fig. 43 . Widespread osteoclastic resorption of bone Fig. 44 increasing width and depth of pocket to form deep intrabony pocket. Pus may exude from pocket mouth or point on attached gingiva. Fig 41 Late...

Chronic periodontitis

Histology Chronic Periodontitis

Aetiology Pcrsistcncc of bactcrial plaque. Progression of inflammation with tissue destruction is a common but not invariable sequel to chronic gingivitis there is wide individual variation for unknown reasons. Microbiology Many potent pathogens e.g. Porphyromonas species, and immunobgy capnocytophaga, Clostridia, fusobacteria, etc. can be isolated from periodontal pockets, but individual roles in tissue destruction are uncertain. Some e.g. Actinomyces species produce bone resorbing factors. A...

Chronic gingivitis

Chronic Gingivitis Histopathology

Aetiology Inflammatory' response to bacterial plaque accumulating at the gingival margin. The bacterial population is mixed with no specific pathogens identified although, initially, bactcria arc Gram-positive and aerobic. An increasing bulk of plaque 100-300 cells thick is associated with increasing prominence of Gram-negative bacteria, such as vcilloncllac, fusobacteria and Campylobacter. The process is probably initiated by leakage of bacterial antigens from plaque in the gingival sulcus....

Apical periodontitis

Acute Periodontitis Apical

Aetiology Secondary lo carics and pulp necrosis in most eases. Trauma lo tooth severing apical vessels. Root canal treatment irritant medicaments or overextension . Pathology Acute accumulation of acute inflammatory cells neutrophils and fluid exudate in potential space between apex and periapical bone Fig. 21 . If neglected, there is suppuration and resorption, usually of buccal plate of bone, and sinus formation on the gum overlying the apex of the tooth. In deciduous molars, inflammation,...

Closed pulpitis

Histopathologic Pic Acute Pulpitis

Typical inflammatory reactions are initially localized to a minute area Fig. 13 but typically lead to necrosis of pulp due to restriction of blood supply by the apical foramen, compression of vessels by oedema in the confined space and thromboses. Pathology All degrees of severity may be encountered, namely acute hyperaemia and oedema Fig. 14 progressive infiltration by neutrophils destruction of specialized pulp cells abscess formation Fig. 15 There is little correlation between symptoms and...